Individual
CHARLES PEMBERTON JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2302 HURSTBOURNE VILLAGE DR STE 300, LOUISVILLE, KY 40299-1843
(502) 491-9720
Mailing address
2302 HURSTBOURNE VILLAGE DR STE 300, LOUISVILLE, KY 40299-1843
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
1169
KY
Other
Enumeration date
11/30/2017
Last updated
11/30/2017
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